Morton’s neuroma

This page has been designed to give you the right information about Morton’s neuroma and what you can do to help with your recovery.

Only got a few minutes? Watch our x min summary of this page to get the key information points

What is a Morton’s neuroma?

A Morton’s neuroma is a small swelling of a nerve that lies between your toes in your foot.  It can lead to a thickening and irritation of the nerve over time.

The nerves that sit between the 3rd and 4th toes tend to be most commonly affected.

What causes a Morton’s neuroma?

There are quite a lot of factors that can influence how and when a Morton’s neuroma forms including:

- A change in the way the foot works or functions caused by bunions or hammer toes
- Certain health conditions such as Rheumatoid arthritis
- Previous injury to the area
- Inappropriate footwear such as a tight-fitting shoe or high heeled shoes
- Less flexible calf muscles

Being female increases your chances of developing a Morton’s neuroma, especially over the age of 50.

Lady shrugging shoulders to indicate confuion.

What are the common symptoms?

Discomfort on walking or occasionally at rest, affecting the toes, particularly the 3rd and 4th toes.

A feeling of pins and needles or numbness (lack of feeling) into the toes.

People will often report a feeling similar to having a stone in your shoe with a Morton’s neuroma.

OK, I think I might have a Morton’s neuroma but what can I do about it?

Firstly, you need to know that you can feel better. Sometimes, these issues can be really quite sore and can get in the way of things that you would normally take for granted and can make you feel like you’ll never get better. However, if it hasn’t settled by itself, clinical input can help.

Understanding your issue is often the best place to start. Reading the information above can help you better understand that Morton’s neuroma is not a damaging or dangerous problem and that it can get better.

Secondly, there are a number of things you can do to help your symptoms settle.

Footwear: What you put on your feet can make a real difference to your symptoms. Wearing tight fitting (especially around the toes) shoes or those with very little cushioning, can often irritate. Choosing a shoe that has a wider fit and more cushioning might be a small but very effective first step towards calming your symptoms down.

Calm it down: Calming your symptoms down might sound like a strange ‘treatment’ but by adjusting and/ or modifying the things that make your feet/ toes sore can be another easy way to help your symptoms settle. Making sensible choices about your shoes has been covered above but you can apply this idea to anything that your foot doesn’t like. A simple example could be that your foot might get irritated if you stand for too long at the moment; by taking small but regular breaks whilst standing might be yet another way to help your recovery. We’ve got more details on calming things down below.

Exercises: Exercises can be another useful thing to add to your option list if you have a Morton’s neuroma. We’ve added a selection of suitable exercises at the bottom of this page for your to explore.

Weight management: Addressing our bodyweight isn’t easy to talk about, let alone actually do. If we are higher than our ideal body weight, it can change the way our feet are used and can sometimes cause, or contribute to issues, including Morton’s neuroma.

If you are interested in exploring how to address weight issues, our local organisations will be able to help.

So, what does ‘calm it down’ mean in more detail?

If you think of your irritated foot as an unhappy worker, then if you keep asking it to do the same job, in the same way that it always has, whilst it is sore it might carry on being sore. In other words, when your foot is sore, imagine it is saying “I can’t do that as easily as I used to at the moment”. Making some changes to the things that are sore may help calm the issue down to allow you to move on with your recovery. Think of it as putting the foot temporarily on lighter duties whilst it’s sore.

Lady shrugging shoulders to indicate confuion.

Can you give some examples of what you mean?

Sure, but remember everyone is different and you will have to do some thinking yourself around how your foot is affecting you and some of the changes you might need to make.

Things that are sore

Why is it sore?

Possible solution?

Wearing shoes

This compresses the nerve and makes it irritated

Wear something which is wider at the toe box and has some cushioning

Walking or standing

This will put more pressure on the nerve

Try and have rest periods where possible

Being barefoot

You might feel a ‘lump’ like feeling the foot. This is because the area is swollen

Avoid being barefoot and use a wider fitting trainer with cushioning

 

We have written a whole page on ‘calming things down’ and called it ‘load management. You can find it here, along with some homework to try to help your foot’s recovery: Load Management.  

How long should I work on ‘calming things down’?

This is a little tricky to be specific about and it is probably best to think about what your foot is saying. If you have been good at adjusting, modifying and looking at the things that make your foot sore, then you should notice some changes within a few short weeks.

Lady shrugging shoulders to indicate confuion.

Ok, what do I do once it feels calmer?

Now that your foot feels somewhat calmer, the temptation might be to start going back to your normal activities in the same way you did before your foot issue. Sometimes this can be ok, but equally, sometimes you might find that your foot is not quite ready to return to normal just yet and may get irritated again. It might be best to think that your foot needs to get fit and strong again in order to get back to doing normal things in normal ways.

As we’ve said before, if you consider your sore foot as an unhappy worker, then you’ve adjusted and modified things (put it on ‘lighter duties’) to help calm it down. Now you’ve got to start a gradual or phased return to work (or normal). Jumping in at the deep end and going back to normal might result in your foot becoming grumpy and sore again.

You haven’t really answered my question!

If your foot is starting to feel a bit easier, you can start to return to your normal activities however, it would be best to build back up to normal levels gradually over several days/ weeks to make sure your foot stays happy.

Lady shrugging shoulders to indicate confuion.

Will it get better?

For most people, a Morton’s neuroma will not be a pleasant experience but reassuringly, it does have the potential to get better. As you might expect, some people might get better more quickly than others but perseverance and patience is often the best thing on your side when dealing with any aches and pains

Frequency asked questions:

A: Normally, a scan is not needed for a Morton’s neuroma. If required, the GP, podiatrist or physio can arrange this for you. In most cases, scans are only needed if the clinician is considering a different treatment option to the one that you are currently undergoing or if they need to check something. Scans are not offered routinely.  

A: Steroid injections for a Morton’s Neuroma can be considered as a useful treatment option however, they are not considered to be 100% effective (Hau et al, 2021).

A: In some cases, if your symptoms fail to improve with the treatments offered then surgery might be considered. This should be considered as the last resort for a Morton’s neuroma and all the other treatment options discussed above should have been exhausted first.

Exercises

Include toe lifts

Lift and spread all your toes while keeping the heel down and the front of your foot on the ground. Once they are spread, push your little toe down and out and repeat with the big toe

Include marble pick up?

Try to shorten your foot while keeping your heel and the front of the foot on the ground but don’t curl your toes

References: Yun Tin Hua, M., Thomson, L., Aujla, R., Madhadevan, D. & Bhatia, M. (2021). Foot and Ankle International. 42(4) 464-468.